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Humeral shaft fracture

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https://www.readbyqxmd.com/read/28131681/intraobserver-and-interobserver-agreement-in-the-classification-and-treatment-of-proximal-humeral-fractures
#1
Mauro E C Gracitelli, Thiago A G Dotta, Jorge H Assunção, Eduardo A Malavolta, Fernando B Andrade-Silva, Kodi E Kojima, Arnaldo A Ferreira Neto
BACKGROUND: There is controversy surrounding the reliability of radiographic measurements and existing classifications for proximal humeral fractures. METHODS: Ten orthopedists, divided into 2 groups by length of experience, evaluated radiographs in 3 views from 40 proximal humeral fractures. We evaluated 11 radiographic criteria (including the Neer and pathomorphologic classifications, head-shaft angle, displacement of the humeral shaft, and lesser and greater tuberosities) and treatment indication...
January 25, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28120001/numerical-investigation-of-fracture-impaction-in-proximal-humeral-fracture-fixation-with-locking-plate-and-intramedullary-nail
#2
Yen-Nien Chen, Chih-Wei Chang, Chia-Wei Lin, Chih-Wei Wang, Yao-Te Peng, Chih-Han Chang, Chun-Ting Li
INTRODUCTION: Fracture impaction is a surgical technique used to support the fractured humerus with locking plate or intramedullary nail when treating proximal humeral fractures. However, few studies have investigated the mechanical difference between fracture impaction with locking plate and with intramedullary nail. The mechanism of fracture impaction to increase stability is still unclear. The aim of this study was to use numerical methods to compare the biomechanical effect of treating proximal humeral fracture...
January 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#3
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#4
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#5
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28065869/predictors-of-radial-nerve-palsy-recovery-in-humeral-shaft-fractures-a-retrospective-review-of-17-patients
#6
N Nachef, V Bariatinsky, S Sulimovic, C Fontaine, C Chantelot
BACKGROUND: Radial nerve injury is common in humeral shaft fractures and fails to recover spontaneously in 30% of cases. Few studies have evaluated predictors of recovery. The objectives of this study were to identify predictors of radial nerve palsy recovery and to assess the usefulness of surgical radial nerve exploration in patients with preoperative radial nerve palsy. HYPOTHESIS: Factors predicting the outcome of radial nerve palsy can be identified. METHODS: Of 373 patients with humeral shaft fractures between 2005 and 2012, 43 had radial nerve palsy, including 23 who were lost to follow-up and 17 who were evaluated retrospectively at a mean of 26 months (range, 12-84 months) after internal fixation...
January 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28050700/when-is-it-safe-to-reduce-fracture-dislocation-of-shoulder-under-sedation-proposed-treatment-algorithm
#7
Konrad Sebastian Wronka, Abhimanyu Ved, Khitish Mohanty
INTRODUCTION: Shoulder dislocations are common. It is known that incongruent shoulder should be promptly reduced. However, when associated with fracture of the proximal humerus, there is a clinical dilemma if reduction under sedation is a safe option. We wanted to establish when it is safe to attempt reduction of a shoulder fracture dislocation under sedation in emergency room. METHODS: This is a retrospective cohort study assessing consecutive patients presenting with a dislocation of a gleno-humeral joint with an associated fracture of the humerus between 2007 and 2015...
January 3, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28040077/closing-the-gap-a-novel-technique-for-humeral-shaft-nonunions-using-cup-and-cone-reamers
#8
Brian T Nickel, Mitchell R Klement, Marc J Richard, Robert Zura, Grant E Garrigues
INTRODUCTION: Nonunion following closed treatment of humeral shaft fracture is estimated to be 5.5%. Many surgical techniques have been described to address humeral shaft nonunion including: open reduction, internal fixation (ORIF) with compression plating and bone graft, dual plating, cortical strut allograft and autograft, and adding biologic augmentation (BMP). The current standard of care includes ORIF with compression plating and bone grafting, but even this technique has an approximated 10% failure rate...
December 2016: Injury
https://www.readbyqxmd.com/read/28040072/biomechanical-testing-to-evaluate-the-cut-through-resistance-of-intramedullary-nails-for-the-proximal-humerus
#9
Maximilian Wanzl, Peter Foehr, Ulrich Schreiber, Rainer H Burgkart, Andreas Lenich
Intramedullary nailing for stabilization of proximal humeral fractures is well-established. Complications as part of a cut-through, such as backing out of locking screws, loss of reduction, and perforation of the screws into the glenoid, are equally well-known. The test bench presented in this study enables testing of the cut-through behavior of multiple intramedullary implants on a simulated osteoporotic three-part fracture configuration with three different loading circumstances (A, B and C). In situation A, the glenohumeral dynamic force with progressive loadings entered at an angle of 15° to the humeral shaft...
December 2016: Injury
https://www.readbyqxmd.com/read/28002327/a-bayesian-network-meta-analysis-of-three-different-surgical-procedures-for-the-treatment-of-humeral-shaft-fractures
#10
Hao Qiu, Zhihui Wei, Yuting Liu, Jing Dong, Xin Zhou, Liangjun Yin, Minhua Zhang, Minpeng Lu
BACKGROUND: The optimal surgical procedure for humeral shaft fractures remains a matter of debate. We aimed to establish the optimum procedure by performing a Bayesian network meta-analysis. METHODS: PubMed, EMBASE, the Cochrane Library, and Medline were searched for both randomized controlled trials and prospective studies of surgical treatment for humeral shaft fractures. The quality of the included studies was assessed according to the Cochrane Collaboration's "Risk of bias"...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27965047/biomechanical-comparison-of-orthogonal-versus-parallel-double-plating-systems-in-intraarticular-distal-humerus-fractures
#11
Ata C Atalar, Onur Tunalı, Ali Erşen, Mehmet Kapıcıoğlu, Yavuz Sağlam, Mehmet S Demirhan
OBJECTIVES: In intraarticular distal humerus fractures, internal fixation with double plates is the gold standard treatment. However the optimal plate configuration is not clear in the literature. The aim of this study was to compare the biomechanical stability of the parallel and the orthogonal anatomical locking plating systems in intraarticular distal humerus fractures in artificial humerus models. METHODS: Intraarticular distal humerus fracture (AO13-C2) with 5 mm metaphyseal defect was created in sixteen artificial humeral models...
January 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27914842/treatment-of-comminuted-proximal-humeral-fractures-using-locking-plate-with-strut-allograft
#12
Hongeun Cha, Ki-Beom Park, Seungbae Oh, Jinyoung Jeong
BACKGROUND: This study compared the radiologic outcome of fixation using locking plate only with fixation using locking plate with an endosteal strut allograft in the treatment of comminuted proximal humeral fracture. METHODS: Among 52 patients with comminuted proximal humeral fracture, 32 patients underwent fixation with locking plate only, and 20 patients underwent fixation using locking plate with an endosteal strut allograft. The strut allograft was inserted into the intramedullary cavity of the humerus to support the humeral head and fixed with the locking plate...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27914660/radiographic-and-clinical-results-of-tension-suture-fixation-using-two-washers-with-philos-plate-for-proximal-humeral-fractures
#13
Chul-Hyun Cho, Du Han Kim, Beom-Soo Kim
INTRODUCTION: The purpose of this study was to evaluate the radiographic and clinical results of tension suture fixation using two washers with PHILOS plate (Synthes, West Chester, PA, USA) for proximal humeral fractures. PATIENTS AND METHODS: Consecutive 39 patients were included and divided into two groups of adequate and inadequate medial support (MS (+) group vs MS (-) group). The mean follow-up period was 45months (range: 26-69 months). The mean age at the time of surgery was 59 years (range: 17-86 years) and there were 12 men and 27 women...
February 2017: Injury
https://www.readbyqxmd.com/read/27909754/dual-plate-fixation-on-distal-third-diaphyseal-fracture-of-the-humerus
#14
Jun-Ku Lee, Yun-Sung Choi, Young-Suk Sim, Dae-Sung Choi, Soo-Hong Han
INTRODUCTION: Displaced unstable distal third fractures of the humeral diaphysis are treated surgically through open reduction and internal fixation. Conventionally, surgeons prefer using long plates for secure fixation; however, we performed short plate dual plating for robust fixation that required a smaller incision and less dissection through an anterior approach. In this study, we report the results of dual plating of fractures of the humeral shaft, with radiographic evidence and clinical analysis...
December 1, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27904716/is-anterior-bridge-plating-for-mid-shaft-humeral-fractures-a-suitable-option-for-patients-predominantly-involved-in-overhead-activities-a-functional-outcome-study-in-athletes-and-manual-laborers
#15
Abhishek S Mahajan, Young Gun Kim, Jae Hwa Kim, Prashanth D'sa, Azhar Lakhani, Hyun Soo Ok
BACKGROUND: To assess the functional and radiological outcomes of minimally invasive anterior bridge plating (ABP) for mid-shaft humerus fractures in patients predominantly involved in overhead activities (athletes and manual laborers). METHODS: Forty-eight patients fulfilling inclusion criteria were treated with ABP at a level-I trauma center using a 4.5-mm dynamic/locking compression plate and followed for a period of 1 year. Functional outcome was assessed using the Constant, Mayo elbow, and Disabilities of the Arm, Shoulder and Hand (DASH) scores...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27872519/the-inflatable-intramedullary-nail-for-humeral-shaft-fractures
#16
Fırat Ozan, Kaan Gürbüz, Erdal Uzun, Sefa Gök, Fatih Doğar, Fuat Duygulu
BACKGROUND: We assessed the results of humeral shaft fracture fixation using the inflatable intramedullary nail using radiological and clinical findings. METHODS: From 2012 to 2015, we treated 14 patients with humeral shaft fractures using inflatable intramedullary nail after closed reduction. RESULTS: The mean follow-up time was 14.1 months. The mean time to bone union was 4.5 months. None of the patients had major perioperative mechanical complications or postoperative complications, except for the occurrence of fixation loss and non-union in one patient...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27822870/a-prospective-study-for-the-treatment-of-proximal-humeral-fractures-with-the-galaxy-fixation-system
#17
R D'Ambrosi, F Palumbo, A Barbato, R M Facchini
BACKGROUND: Fractures of the proximal humerus represent a common problem in clinical practice; in particular for three- or four-part fractures, there is no consensus regarding which is the best treatment. The aim of our study was to report clinical and radiological outcomes in patients treated with the Galaxy Fixation System™ for a proximal humerus fracture. MATERIALS AND METHODS: Thirty-two patients of which 18 (56.25%) women, and 14 (43.75%) men suffering from proximal humerus fractures were treated using the Galaxy Fixation System™...
November 7, 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27812778/retrospective-analysis-of-extra-articular-distal-humerus-shaft-fractures-treated-with-the-use-of-pre-contoured-lateral-column-metaphyseal-lcp-by-triceps-sparing-posterolateral-approach
#18
Yatinder Kharbanda, Yashwant Singh Tanwar, Vishal Srivastava, Vikas Birla, Ashok Rajput, Ramsagar Pandit
Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach...
November 3, 2016: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/27812728/-regeneration-of-a%C3%A2-radial-nerve-after-compression-under-an-osteosynthesis-plate
#19
Burghard Jacoby, Konrad Wasylewski, Wolfgang Zinser
In approximately 4-13 % of cases plating of the humerus for stabilizing a shaft fracture is complicated by a secondary lesion of the radial nerve. In the majority of cases this is due to intraoperative traction on the nerve. The compression of a radial nerve under an osteosynthesis plate is reported only rarely. This article presents the case of a spontaneous regeneration of a radial nerve despite ongoing compression by the surgical implant after compression plating of a humeral shaft fracture. Recommendations are given to avoid such an iatrogenic lesion of the radial nerve, which most commonly is not spontaneously reversible...
November 3, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27807109/quality-of-reduction-influences-outcome-after-locked-plate-fixation-of-proximal-humeral-type-c-fractures
#20
Marc Schnetzke, Julia Bockmeyer, Felix Porschke, Stefan Studier-Fischer, Paul-Alfred Grützner, Thorsten Guehring
BACKGROUND: The aim of this study was to determine if fracture reduction, fracture pattern, and patient-related factors influence clinical outcome after locked-plate fixation of displaced proximal humeral fractures. METHODS: Ninety-eight patients (mean age, 61.1 ± 11.2 years) with a proximal humeral fracture involving the anatomical neck (type C according to the OTA/AO classification system) were included. Clinical outcome was determined by age and sex-adjusted Constant score (CS%) and the Disabilities of the Arm, Shoulder and Hand (DASH) score...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
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